Bone mineral density of the femoral neck was measured by dual-energy x-ray absorptiometry (DEXA) using a densitometer (Hologic QDR-4500A; Hologic Inc, Waltham, Mass). At this measurement site, the precision (coefficient of variation) is 1.2% according to the manufacturer. Measurements of the levels of serum total calcium, phosphate, alkaline phosphatase, γ-glutamyl-transpeptidase, and aspartate transaminase were performed by an autoanalyzer; their normal ranges, respectively, are 8.4 to 10.2 mg/dL (2.1-2.6 mmol/L), 3.5 to 4.5 mg/dL, 50 to 110 U/L, 15 to 40 U/L, and 16 to 45 U/L. Serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were determined by saturation analysis (SmithKline Laboratories, Philadelphia, Pa); their normal ranges, respectively, are 10 to 45 ng/mL and 15 to 60 pg/mL. Serum intact parathyroid hormone (SmithKline) and free testosterone (Diagnostics Product Corp, Los Angeles, Calif) levels were determined by radioimmunoassay; the luteinizing hormone level was measured by an enzyme-linked immunosorbent assay (Bayer Diagnostics, Tarrytown, NY); their normal ranges, respectively, are 15 to 54 pg/mL, 9 to 45 ng/mL, and 3 to 11 mIU/mL. A serum sample was lacking for measurement of the following levels: 1,25-dihydroxyvitamin D, 7 patients; parathyroid hormone, 4; testosterone, 3; 25-hydroxyvitamin D, 1; and phosphate, 1.